Li Zhenzhou, Xu Xianfeng, Ren Lijie, Shao Yufeng, Luo Shuyu, Chen Shenghua, Guan Xiaoyun
Department of Ultrasound, The Second People's Hospital of Shenzhen, The First Affiliated Hospital of Shenzhen University, Shenzhen, China.
Department of Obstetrics and Gynecology, The Second People's Hospital of Shenzhen, The First Affiliated Hospital of Shenzhen University, Shenzhen, China.
Front Pharmacol. 2019 Jun 21;10:672. doi: 10.3389/fphar.2019.00672. eCollection 2019.
To evaluate the relationship between contrast-enhanced ultrasonography (CEUS) of carotid intraplaque neovascularization and ischemic stroke in transient ischemic attack (TIA) patients. A total of 112 TIA patients were selected for the study. Routine carotid ultrasonic examination was performed for all the patients. CEUS was carried out for consecutive patients with plaque thicker than 2.5 mm in carotid bifurcation and follow-up for at least 24 months. The number of patients with incurrence of ischemic stroke or recurrence of TIA was obtained during the follow-up period. To detect the risk factors for incurrence of ischemic stroke or recurrence of TIA in 24 months, multivariate logistic regression analyses were performed for all the risk factors in all the selected patients. Ninety-one patients underwent CEUS and were followed up at least 24 months. There were statistical differences between recurrent and non-recurrent groups about hypertension, diabetes, hyperlipemia, smoking history, family history of stroke, medication compliance, two-dimensional ultrasound, and CEUS ( < 0.05). The higher CEUS intensity in the carotid plaque was, the higher was the possibility of ischemic stroke or recurrent TIA. Multivariate logistic regression analysis showed that the CEUS characteristics of carotid plaque such as linear enhancement or diffuse enhancement were independent risk factors for ischemic stroke or recurrent TIA in TIA patients ( < 0.05). For carotid plaques, CEUS could evaluate the infusion mode, which could reflect the neovascularization in plaques. CEUS could predict the incurrence of ischemic stroke or recurrence of TIA in TIA patients, which is useful information when making a clinical decision.
评估短暂性脑缺血发作(TIA)患者颈动脉斑块内新生血管的超声造影(CEUS)与缺血性卒中之间的关系。共选取112例TIA患者进行研究。对所有患者进行常规颈动脉超声检查。对颈动脉分叉处斑块厚度大于2.5 mm的连续患者进行CEUS检查,并随访至少24个月。随访期间记录缺血性卒中发生或TIA复发的患者数量。为检测24个月内缺血性卒中发生或TIA复发的危险因素,对所有入选患者的所有危险因素进行多因素logistic回归分析。91例患者接受了CEUS检查并至少随访24个月。复发组与未复发组在高血压、糖尿病、高脂血症、吸烟史、卒中家族史、用药依从性、二维超声及CEUS方面存在统计学差异(P<0.05)。颈动脉斑块内CEUS强度越高,缺血性卒中或TIA复发的可能性越大。多因素logistic回归分析显示,颈动脉斑块的CEUS特征如线性增强或弥漫性增强是TIA患者缺血性卒中或TIA复发的独立危险因素(P<0.05)。对于颈动脉斑块,CEUS可评估灌注模式,其能反映斑块内新生血管情况。CEUS可预测TIA患者缺血性卒中的发生或TIA的复发,这在临床决策时是有用的信息。